To discuss the learning curve and clinical experience of laparoscopic pancreatoduodenectomy (LPD).

Clinical data of 50 patients who underwent LPD in the First Affiliated Hospital of Bengbu Medical College from January 2015 to March 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 26 patients were male and 24 female, aged (60±10) years old on average. All the patients were divided into the early stage group (n=25) and late stage group (n=25) according to the date of operation. All operations were completed by the same group of surgeons. Perioperative conditions and postoperative complications were observed between two groups. The operation time was statistically compared between two groups by t test. The correlation between body mass index (BMI) and operation time was conducted by linear correlation analysis.

In the early stage group, 4 patients were converted to open surgery, and 2 cases in the late stage group. The remaining patients underwent LPD successfully. In late stage group, the average operation time and pancreaticojejunostomy time were (406±38) min and (42±7) min respectively, significantly shorter than (457±62) min and (53±7) min in early stage group (t=-3.86, -5.34;P<0.05). However, the intraoperative blood loss, postoperative ventilation time, length of postoperative hospital stay and complications did not significantly differ between two groups (P>0.05). BMI was positively correlated with the operation time in early stage group (r=0.493, P<0.05).

LPD is a complex procedure with long operation time and more postoperative complications. Nevertheless, certain optimization and training can gradually shorten the operation time and guarantee the safety of operation, making it possible to performing LPD routinely.